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Individual

MS. IVETTE LOPEZ BLEDSOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
1360 CADUCEUS WAY BLDG 400, SUITE 102, WATKINSVILLE, GA 30677-7300
(706) 286-8442
Mailing address
1341 ARIZONA BND, WATKINSVILLE, GA 30677-7774
(678) 726-0211

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
627
CO
1041C0700X
Clinical Social Worker
Primary
CSW005801
GA

Other

Enumeration date
09/16/2006
Last updated
09/02/2016
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